Is Food Addiction a Specific Feature of Individuals Seeking Dietary Treatment from Nutritionists?

Objective: Food addiction (FA) is a condition characterized by excessive and dysregulated consumption of high-energy food, and impulsivity. The diagnostic and nosological framework of FA is still controversial. Therefore, this study aimed at exploring the prevalence of FA in patients seeking help from nutritionists for weight loss, along with its relationship with eating habits, in a pool of 842 participants of both sexes. Method: Eating habits and FA were assessed by, respectively, a self-administered questionnaire and the Yale Food Addiction Scale (YFAS). Statistical analysis included Chi-square for categorical variables, independent t tests to investigate continuous variables and an univariate logistic regression analysis to determine potential risk factors for FA. The relationship between FA diagnosis and potential risk factors was assessed through a stepwise logistic regression model, controlling for age, sex, and body mass index (BMI) classes. Results: Our results indicate that a prevalence of FA in our sample was 15.3%, with no difference between women and men. A higher prevalence was recorded in overweight subjects or obese. According to the YFAS criteria, women were more likely to report a persistent desire and withdrawal than men. Patients with FA compared with those without it, reported a greater number of attempts to lose weight, to self-dieting, a different mealtime repertoire, and to nibble continuously throughout the day. Moreover, the amount of carbohydrates ingested in the same meal seems to represent an eating habit significantly associated with FA. Conclusions: Taken together, our findings show how patients seeking help from nutritionists may display some peculiar features of FA. In spite of its diagnostic controversies, it is evident that FA may play a role in obesity and may also be a feature of some psychopathological conditions. Therefore, it should be more deeply investigated and possibly specifically targeted with tailored therapeutic interventions.

Food addiction: is it a nosological category or a psychopathological dimension? Preliminary results of an Italian study.

Background Food addiction (FA) is a controversial concept, denoting the craving for certain foods. Given the little information available, the aim of this study was to evaluate the possible relationships between FA and full-blown and subthreshold psychopathology or eating behaviors in subjects consulting nutritional biologists. Materials and methods Three-hundred and fifty subjects completed the following self-questionnaires: Yale Food Addiction Scale (YFAS), Structured Clinical Interview for Mood Spectrum, Self-Report, Lifetime Version (MOOD-SR-LT), Symptom Checklist-90-Revised (SCL-90-R), Structured Clinical Interview for Anorexic-Bulimic Spectrum, Self-Report, Lifetime Version (ABS-SR-LT). Results Most of the subjects were women (n = 278) and the remaining were 72 men. A large proportion of the subjects (77.1%) had a YFAS score <3 and 22.9% ≥3, with no difference between men and women. The YFAS scores ≥3 were significantly and positively related to the all ABS-SR-LT domains, as well as to three dimensions (Depression, Hypomania, Rhythmicity) of the MOOD-SR-LT, and some SCL-90-R domains (Sensitivity, Psychoticism, General Symptom Index and Positive Symptom). Conclusion Our data, while indicating that FA is related to different subthreshold psychopathological domains, in particular, with both depressive and manic symptoms, as well as with rhythmicity of mood spectrum, or with eating subthreshold symptoms, would suggest that it might be a dimension underlying different conditions or symptom clusters.

Maternal-foetal attachment independently predicts the quality of maternal-infant bonding and post-partum psychopathology.

PURPOSE: The aim of this study was to evaluate the association of maternal antenatal attachment and post-partum psychopathology, maternal-infant bonding, while checking for antenatal psychopathology, for lifetime psychiatric diagnosis and for the known risk factors for peripartum depression. METHODS: One hundred and six women recruited at the first month of pregnancy (T0) were evaluated with the structured interview for DSM-IV TR (SCID-I) to assess the presence of lifetime psychiatric diagnosis and with the Perinatal Depression Predictor Inventory-Revised (PDPI-R), the Edinburgh Postnatal Depression Scale (EPDS), and the State-Trait Anxiety Inventory (STAI). At the sixth month of pregnancy (T1) and at the first month post-partum (T2), all patients were evaluated with the PDPI-R, the EPDS, the STAI, at T1, with the Maternal Antenatal Attachment Scale (MAAS), and at T2 with the Maternal Postnatal Attachment Scale (MPAS). RESULTS: Multivariate regression analyses showed that maternal-foetal attachment was the variable most significantly associated with postnatal symptoms of depression and anxiety and with quality of maternal-infant attachment. The logistic regression analyses showed that antenatal attachment may predict postnatal depressive and anxiety symptoms (respectively, OR: 0.83 - IC [0.74 - 0.95], p = .005, OR: 0.88 - IC [0.79 - 0.98], p = .02), and the quality of maternal postnatal attachment (OR: 1.17 - IC [1.08 - 1.27], p < .001), also after taking into account the known risk factors for perinatal depression, the sociodemographic variables and lifetime psychiatric diagnosis. CONCLUSION: The quality of maternal-foetal bonding may independently predict the quality of maternal-infant attachment and post-partum depressive and anxiety symptoms. A comprehensive assessment of maternal risk factors for perinatal psychopathology during pregnancy should include the evaluation of antenatal attachment that could be modifiable by specific interventions promoting the quality of maternal bonding.

Barrett's esophagus in anorexia nervosa: a case report.

Barrett's esophagus (BE) is a metaplastic lesion that may result from long-lasting gastroesophageal reflux and it is an established precursor of esophageal adenocarcinoma. There are reports of an increased prevalence of BE, and eventually esophageal adenocarcinoma, in patients with eating disorders characterized by purging behaviors like those with bulimia nervosa (BN). Among patients with eating disorders, those affected by anorexia nervosa binging purging subtype (ANBP), are behaviorally very similar to those with BN, but to our knowledge there are no data in literature about BE in patients with ANBP. We present the case of a 37-year-old female with a 20-year history of ANBP in comorbidity with bipolar disorder, who developed a BE requiring multi-specialistic intervention.

Issues in the management of acute agitation: how much current guidelines consider safety?

Agitated behavior constitutes up to 10% of emergency psychiatric interventions. Pharmacological tranquilization is often used as a valid treatment for agitation but a strong evidence base does not underpin it. Available literature shows different recommendations, supported by research data, theoretical considerations, or clinical experience. Rapid tranquilization (RT) is mainly based on parenteral drug treatment and the few existing guidelines on this topic, when suggesting the use of first generation antipsychotics and benzodiazepines, include drugs with questionable tolerability profile such as chlorpromazine, haloperidol, midazolam, and lorazepam. In order to systematically evaluate safety concerns related to the adoption of such guidelines, we reviewed them independently from principal diagnosis while examining tolerability data for suggested treatments. There is a growing evidence about safety profile of second generation antipsychotics for RT but further controlled studies providing definitive data in this area are urgently needed.